Patient Abandonment

[PMFB-RN, RN]

For the last 20+ years I've been casual at a tiny (12 bed) rural critical access hospital. I mainly work there because its a lot of fun and I'm often the only RN on duty.

The hospital has an attached small nursing home. It's usually staffed with one nurse, usually an RN but sometimes an LPN at night and 2 or 3 CNAs.

Last week my phone rang in the middle of the night and it was the DON of the hospital/nursing home calling me from out of state where she was on vacation. She asked my to come in and cover the nursing home for a few hours as the LPN on duty couldn't be found.

One of the CNAs went to talk to the nurse and couldn't find him. After a search of the bathrooms and other usual places failed to turn up the nurse the CNA called the DON, who called me and the police.

I know NOTHING about nursing home nursing. I've spent my whole career  in critical care and ER but I agreed to go in to "just be there". I arrived at about 3AM, the LPN had been missing for about an hour. 

The only deputy sheriff on duty in the (very rural) county showed up and conducted a search of the surrounding area that also failed to find the missing nurse.

About an hour before shift change (so absent about 4 hours) the missing nurse strolls in through the front door and was very surprised to see me there. I called off the cop and also let the DON know her missing LPN had returned. I questioned him and he didn't hesitate to tell me that he had left to spend some time with his girlfriend and, even more shocking, admitted that he often would visit her during his shift and didn't understand what the problem was "everything was quiet".

The DON asked me to inform him he was fired and collect his badge and keys from him. She has since been in contact with the state board of nursing and is fully confident he will lose his license. I sure hope he does. I had to write a report of the discussion I had with him when he arrived back to the NH for the board.

I'm blown away that a licensed nurse would see no issue with leaving his patients for hours when there was no other nurse in the building. 

[Jedrnurse, BSN, RN]

BUT, BUT, "everything was quiet"...?

Seriously though, it does boggle the mind.

 

BTW, if I were you, I'd nip that getting called in the middle of the night thing to cover the SNF in the bud. Once you've marked yourself as a one-person staffing pool, it'll be tempting for them to keep bugging you.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

9 hours ago, PMFB-RN said:

For the last 20+ years I've been casual at a tiny (12 bed) rural critical access hospital. I mainly work there because its a lot of fun and I'm often the only RN on duty.

   The hospital has an attached small nursing home. It's usually staffed with one nurse, usually an RN but sometimes an LPN at night and 2 or 3 CNAs.

    Last week my phone rang in the middle of the night and it was the DON of the hospital/nursing home calling me from out of state where she was on vacation. She asked my to come in and cover the nursing home for a few hours as the LPN on duty couldn't be found.

    One of the CNAs went to talk to the nurse and couldn't find him. After a search of the bathrooms and other usual places failed to turn up the nurse the CNA called the DON, who called me and the police.

    I know NOTHING about nursing home nursing. I've spent my whole career  in critical care and ER but I agreed to go in to "just be there". I arrived at about 3AM, the LPN had been missing for about an hour. 

   The only deputy sheriff on duty in the (very rural) county showed up and conducted a search of the surrounding area that also failed to find the missing nurse.

    About an hour before shift change (so absent about 4 hours) the missing nurse strolls in through the front door and was very surprised to see me there. I called off the cop and also let the DON know her missing LPN had returned. I questioned him and he didn't hesitate to tell me that he had left to spend some time with his girlfriend and, even more shocking, admitted that he often would visit her during his shift and didn't understand what the problem was "everything was quiet".

   The DON asked me to inform him he was fired and collect his badge and keys from him. She has since been in contact with the state board of nursing and is fully confident he will lose his license. I sure hope he does. I had to write a report of the discussion I had with him when he arrived back to the NH for the board.

   I'm blown away that a licensed nurse would see no issue with leaving his patients for hours when there was no other nurse in the building. 

This idiot fired himself! As I was reading this, I was thinking he was gonna be found somewhere with at least a half-a**-believable lie. But the dumb*** told the truth!! He must have been one of the ones who cheated his way through nursing school and failed to read the legalities and ethics chapter...only memorized the answers from the test banks with reading the wherewithal. One down, how many to go??

[PMFB-RN, RN]

41 minutes ago, Jedrnurse said:

BUT, BUT, "everything was quiet"...?

Seriously though, it does boggle the mind.

 

BTW, if I were you, I'd nip that getting called in the middle of the night thing to cover the SNF in the bud. Once you've marked yourself as a one-person staffing pool, it'll be tempting for them to keep bugging you.

That's good advice but I have it handled. I have a very long relationship with this hospital. The DON used to be my nursing student and is a friend of my wife's. I'm fishing buddies with two of the 3 physicians who practice there.

    Its not and never has been my full time job. I see being casual there as more like serving on a volunteer fire department.  A way to give back to the community. Plus I actually have a ton of fun there. Like the time I was the only person in the building (Family practice doc taking ER call from home) when a man came in at 1AM carrying his white-as-a-sheet 12 year old daughter. Mom came in behind him with the girl's arm in a plastic bag. She fell off the boat which then ran her over and cut off her arm. No detectable pulse (was able to dopple a carotid pulse), RR like 6. Intubated her, Placed a tourniquet, popped in 2 IOs and started 2 units of O-neg on the Level I rapid infuser. Had her 16 year old sister standing there in her swimming suit running the ambu bag cause I didn't have enough hands. Finally had a chance to page the doc who then took about 15 minuets to get back to me, and another 20 minuets to arrive, and wasn't much use when she arrived.

    By then I had giver her 4 units of PRBCs she had enough blood pressure that she was starting to wake up and fight the tube and I had to give her some fentanyl and versed.

    Called the only deputy on duty that night who woke up the only tow truck operator in the county to move some cars out of the way in the parking lot so the helicopter could land to take her to the university hospital. We had a helicopter landing pad but it was being renovated. 

    I have lots of good stories from working there. Plus when I'm there I'm the house supervisor (supervising myself and maybe one CNA) which looks good on my resumé.

    They know better than to call me except in an emergency and that usually means it's going to be a good time. 

[Davey Do]

WOW! PMFB-RN, great stories!

I, too, worked in small 19 bed rural community hospital with an attached 40 bed LTC facility in the early '90's. My one life-saving ER story pales in comparison to yours, so there's no way that I'm going to steal your thunder!

As far as the rogue nurse goes, the behavior reeks of a sociopath who has been enabled by some of his coworkers. In my 36 year nursing career, I did not experienced the like, to that degree, of patient abandonment.

[JKL33]

12 hours ago, PMFB-RN said:

She has since been in contact with the state board of nursing and is fully confident he will lose his license.

If my family member was in that place I'd be looking for a lot more accountability than just that.  How do you have an employee who does this (in the first place)--and an employee who has been getting away with this for who knows how long?

And what was the back-up plan for the DON being out of state on vacation?

[PMFB-RN, RN]

14 minutes ago, JKL33 said:

If my family member was in that place I'd be looking for a lot more accountability than just that.  How do you have an employee who does this (in the first place)--and an employee who has been getting away with this for who knows how long?

And what was the back-up plan for the DON being out of state on vacation?

He's only worked there 6 weeks or so off orientation. 

   I'm the back up to the DON. Only reason the ringer on my phone was turned on.

[Davey Do]

This so called "idiot" is not, for he was intelligent enough to manipulate his media to the point that he was able to achieve a desired outcome; he   had the power to gain an ally in other staff and leave in order to be with his girlfriend.

A sociopath, on the other hand, manifests extreme cases of aberrant attitudes and behavior and shows a lack of conscience.

Chances are, this individual has no remorse for his wrongdoings and needs to have to deal with the ramifications of his actions e.g. loose his license. Subsequently, he may rightly loose his license, yet he possesses a rationale system that would choke a horse and will go on unencumbered to repeat this behavior elsewhere. Just not as a nurse.

Axis II personalities. Ya gotta love 'em.

[amoLucia]

7 hours ago, Jedrnurse said:

BTW, if I were you, I'd nip that getting called in the middle of the night thing to cover the SNF in the bud. Once you've marked yourself as a one-person staffing pool, it'll be tempting for them to keep bugging you.

It was a one-time emergency. I'd not quibble over that call. The priority was to provide nsg presence. I can't think of any other kind of emergency that might out-rank the situation that nite.

 

[Jedrnurse, BSN, RN]

23 minutes ago, amoLucia said:

It was a one-time emergency. I'd not quibble over that call. The priority was to provide nsg presence. I can't think of any other kind of emergency that might out-rank the situation that nite.

 

I was more anticipating repeats, especially considering that the night nurse is now fired...

[2BS Nurse, BSN]

Wow, do you have standing orders to do all of the above with that 12 year old? I suppose in a small town it wouldn't come back to bite you.

[mtmkjr, BSN]

That's my recurring dream... being absent from my patients and coming to the end of my shift not having done any assessment, given any meds, treatments, no documentation.... It's my nightmare actually. And here we have someone doing it purposefully...?!